Luxation injuries, maxillofacial and soft tissue injuries

Question 0

what are the characteristics of a concussion luxation?

Answer 0

No abnormal loosening or displacement of the tooth
Marked response to percussion
usually positive sensibility testing

Question 1

what are the types of luxation injuries that can present?

Answer 1

1) Concussion
2) Subluxation
3) Lateral luxation
4) Intrusive luxation
5) Extrusive luxation

Question 2

what is the management for a concussion luxation injury?

Answer 2

Initial management:
Radiographs, vitality testing, reassurance, soft diet for 7 days, excellent OHI with CHX, advice reggarding sequalae
Follow-up:
4 weeks, 6-8 weeks and then yearly

Question 3

What is the average sequalae of concussion luxations in the primary dentition in about 10 years?

Answer 3

3.5% loss of vitality
8% surface resorption
6 - 10% pulp canal obliteration

Question 4

WHat are the characteristics of subluxation?

Answer 4

Abnormal loosening without displacement. Damage too PDL with possible damage to neurovascular bundle but may have areas of undamaged PDL
TTP, mobility increased, bleeding gingival margin

Question 5

How should a tooth that has been subluxated be managed?

Answer 5

Initial mmanagement:
Radiographs, vitality testing, reassurance, soft diet for 7 days, excellent OH with CHX mouthrinse, advise on sequalae, splinting for patient confort for up to 2 weeks
Follow up:
4 weeks, 6-8 weeks, and then yearly.

Question 6

what is the average sequalae of subluxation in the primary tooth?

Answer 6

11.5% lose vitality
2.7% surface resorption
9-13% pulp canal obliteration

Question 7

what are the characteristics of a lateral luxation?

Answer 7

The tooth is displaced other than along the long axis (Either palatally or labially).
If the crown is displaced palatally, the roots can move bucally and fracture the buccal plate.
Percussion usually gives a high ankylotic tone, sensibility test normally give negative results, widened PDL space

Question 8

What are the three presentations of a lateral luxation??

Answer 8

Tooth mobile
Tooth ffirm with occlusal interferences
Tooth firm without occlusal interferences

Question 9

How should a tooth that has been laterally luxated be managed if it iss mobile?

Answer 9

Reposition with flexible wire and splint for 2 weeks. Advise soft diest, CHx mouthrinse, assess mobility after 2 weeks.
HOwevver, check buccal plate and if fractured, splint is left on for 4 weeks.